Sally Kiss, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

122296 Issued in MA

Practice address

455 Sea St Unit 1B
Quincy, MA 02169-2704

Phone

(617) 396-4483

Fax

(617) 687-8472

NPI assigned

Aug 5, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Authentic Connections CounselingGroup PAC ID 3274067442, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Authentic Connections Counseling

  • Clinical Social Worker
  • Quincy, MA
  • NPI 1093406951
  Medicare reassignment Care Compare group NPD Authorized official
• Mindful Journey Counseling, Inc.

  • Clinical Social Worker
  • Quincy, MA
  • NPI 1124712328
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1235515883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SEA ST UNIT 1B",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021692704",
            "telephone_number": "617-396-4483",
            "fax_number": "617-687-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SEA ST UNIT 1B",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021692704",
            "telephone_number": "617-396-4483",
            "fax_number": "617-687-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISS",
        "first_name": "SALLY",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2023-05-19",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kings Enterprize
• Kathleen Burns Kingsbury, LMHC
• Laura Kirschner
• Rohan Shantanu Kirtane, D.M.D, A.E.G.D
• Dawayne D Kirton Jr.
• Timothy J Kistler, D.C.
• Janyce G Kittler, LICSW
• Bridget L Kittredge, L.D.O.
• Maria M Klisiaris, M.ED.
• Melinda Jean Kneeland

• Clinical Social Worker in Quincy, MA
• Providers in Quincy, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.